台北中医医学杂志

105.13 虚劳中医治疗病例报告
虚劳中医治疗病例报告
Traditional Chinese Medicine in the
Treatment of Chronic Fatigue Syndrome :
A Case Report
林芳谊2 王玟玲1,2,.3*
【摘要】
慢性疲劳症候群(Chronic fatigue syndrome, CFS) 又称为肌痛性脑脊髓炎
(Myalgic encephalomyelitis, ME) 是一种常见但致病机转仍未明的疾病,许多研究提
到可能和中枢神经、自律神经、免疫系统和能量代谢有关。此个案为65 岁女性,自一
年前起晨起头重痛、头晕,伴随明显身倦感、全身酸痛与眼乾。近期的抽血检验皮质醇
(Cortisol) 和促甲状腺激素(TSH) 无异常。经辨证论治,中医病名为虚劳,证型诊断为
气阴两虚型,治则为补脾气、滋肝阴,中药处方以杞菊地黄丸和加味逍遥散加减。中医
典籍记载虚劳最早见於《素问∙通评虚实论》:「邪气盛则实,精气夺则虚。」而明代《理
虚元鉴》提出:「治虚有三本,肺、脾、肾是也。」然而,现代人虚劳常与情志问题有关,
故病机以木气失调为主、中土失运为次,日久引起火金水三气失司,此与古代医家治疗
虚劳重视肺、脾、肾三脏的想法不同,显现出时空环境改变病因病机也随之更迭。
【关键词】慢性疲劳症候群;虚劳;气阴两虚
Fang-Yi Lin2 Wen-Ling Wang1,2,3*
1Department of Chinese Medicine, China Medical University Hospital Taipei Branch, Taipei, Taiwan
2Department of Chinese Internal Medicine, China Medical University Hospital, Taichung, Taiwan
3School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
【Summary】
Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is an illness of uncertain cause. While many theories indicate that the central and autonomic nervous
systems, the immune system, and energy metabolism may be involved, these findings
have not yet led to a clear understanding of pathophysiology or to a diagnostic test of
adequate sensitivity and specificity. In this case, a 65-year-old female has been suffered
from dizziness, headache, head pressure with an overall feeling of fatigue, soreness, and
dry eyes. Recent lab data showed cortisol and TSH levels were in the normal range. The
pattern type is dual vacuity of qi and yin. The principle of treatment is to supplement qi
and to enrich yin. The prescription is Lycium Berry, Chrysanthemum, and Rehmannia Pill
combined with Supplemented Free Wanderer Powder. In ancient Chinese books, chronic
fatigue syndrome mainly involved the lung, spleen, and kidney. Modern people with chronic fatigue syndrome, however, are caused by emotional distress and the liver qi should be taken into consideration.
【Keywords】 Chronic Fatigue Syndrome, tiredness, dual vacuity of qi and yin